Thursday, September 2, 2010

Experts are urging health authorities to bring in a nationwide screening programme and free vaccines to protect women against cervical cancer - the second biggest killer of females in the UAE, after breast cancer.

A month-long drive to smash taboos and boost awareness among mothers, daughters, sisters and wives is now under way.

The Everything I Can awareness campaign is running throughout November and has been set up by pharmaceutical firm Merk, Sharpe and Dohme with the support of UAE health authorities. Community outreach, advice sessions from experts and information packs are all part of the programme.

Meanwhile specialists are urging the UAE government to make tackling the cancer a priority.

“In developed countries, there is a national screening programme. In the UAE we don’t have that and we need it,” says Dr Faisal Tazyeen, a Gynaecologist at Medgate Clinic in Dubai. “Early detection is the key to preventing this type of cancer.”

The latest figures show that nine in 100,000 women in the UAE are diagnosed with cervical cancer - 75 per cent of which are in the latter stages of the disease, meaning chances of survival are slim.

In short, it is left far too late for many women to stand a chance of beating the illness - the only type of cancer that is 100 per cent preventable with a combination of vaccines and screening.

“By the time is it diagnosed as cancer, it is already late,” said Tazyeen. “There are various stages of development which have no symptoms but can be picked up early by regular screenings. We need to get this message out - that it can be entirely prevented. “And that waiting until you have symptoms such as pain and irregular bleeding means it is too late.”

Cervical cancer is caused by the Human Papilloma Virus (HPV), which is carried by 630 million people worldwide and has more than 100 different strains. Most types are dealt with by the body’s own immunity but there are about six that can cause cancer of the cervix.

A vaccine has been developed to fight HPV and is available free of charge in European countries.

But this is not the case in the UAE. The treatment is available privately, at a cost of about dhs1,800.

The assistant head of gynaecology and obstetrics at Al Wasl Hospital, Dr Muna Tahlak, said vaccinations can be given to girls as young as nine to guard against HPV and believes it should be available for free in this country.

“The evidence so far suggests the vaccine has a major impact of preventing the development of the cancer.

When you take into account how much the treatment of the disease costs, it makes sense for the government to invest in the vaccine.”

The Ministry of Health has said it is currently considering plans to introduce a national screening programme.

Facts Cervical cancer

What is cervical cancer?
Cervical cancer develops when abnormal cells in the lining of the cervix begin to multiply out of control in response to HPV infection.

How is it diagnosed?
The smear test (also called Pap smear) is a simple procedure, usually conducted in a doctor’s office or clinic, that detects abnormal or cancerous cervical cells. Because it can detect cervical changes before they progress to cancer, it is vital women get checked.

Is the test painful?
You might experience some discomfort but it is over in seconds and could save you the ordeal of serious health problems in the future.

How often should I have the smear?
Once a woman is sexually active she should have the test once a year. If low-grade abnormalities are found, she should be checked every three months or every six months. Your doctor can advise you on this.

Where can I get tested?
To be tested at a hospital, you will generally need a referral from a doctor - all you need to do is ask. Most medical centres offer smear tests.  Private patients will have to pay about dhs300 for the smear. It is free to UAE nationals.

Who is at risk?
Any woman is at risk as soon as she is sexually active. A HPV infection can develop in a married woman who has had one partner or a single woman who has had multiple partners. Cervical cancer most commonly effects women in their 30s and 40s. As it can take 20 years to develop from HPV to cancer, this means the virus could have been spotted and treated in the majority of cases if the woman had been screened earlier.

What are the symptoms?
The HPV infection has no symptoms. The only way to find out if you have it is to have a smear test. Irregular vaginal bleeding, pain and vaginal discharge can be symptoms of cervical cancer but by the time these are presented in a patient, chances of survival are greatly reduced.

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It can happen to anyone
Case study: Gynaecologist Dr Faisal Tazyeen, of Medgate Hospital, recalls a case where leaving symptoms too long lead to a bleak outlook for one patient.

“Recently, I had a Filipina lady come to me who was bleeding irregularly.

She had been to a GP about nine months earlier and had been given drugs to stop it but had never been screened. By the time I saw her, she had been experiencing this for about a year. This is one of the signs of late stage cervical cancer.

When I examined her, the cancer could be seen with the naked eye, which is very advanced. The treatment options by this stage are chemotherapy and radiotherapy. This lady returned to the Philippines for treatment. She was 42.”

Case study: Assistant head of obstetrics and gynaecology at Al Wasl Hospital, Dr Muna Tahlak says many potential cases can be prevented by regular checks.

“A 23-year-old girl came to me crying because she’d been screened at a clinic and been told she had low-grade abnormality.

She was in distress and saying she had cancer.

But that’s not the case. Abnormalities are graded from one to three.

I took a closer look at her and took a biopsy and confirmed she had a grade one abnormality.

In this case, you don’t need treatment, you need to be aware and be checked regularly. An abnormality is not necessarily serious but you need to get yourself checked as things can change quickly.”